By Tom Lacock
Wyoming Medical Society
CASPER – Despite cold temperatures and a winter storm bearing down on Central Wyoming, nearly 70 physicians, legislators, insurance executives, and facility directors took part in an insurance forum at The Petroleum Club in Casper, Tuesday.
“I thought it went great,” McGinley said after the event. “I think we accomplished more than we expected. We let the insurance companies know how we felt.”
The event was sponsored by the Natrona County Medical Society (NCMS) with its president, Joe McGinley, MD, PhD moderating the panel discussion with Rick Schum (Blue Cross/Blue Shield); Tom Glause (State Insurance Commissioner); Tom Forslund (Wyoming Department of Health); Kim Bimestefer (Cigna); Dean Groskopf (Cigna); and Mark Laitos, MD (Cigna); and Cara Beatty(United HealthCare).
“If we can build an incubator in Casper and keep this dialog going around healthcare, I think we can make a difference,” Schum Tuesday. “We need to have a meaningful discussion. This is a system that has to work.”
The discussion went for nearly two hours with questions submitted ahead by NCMS of time on patient care, insurance service, and the hope of getting patients more involved in their own care from a wellness standpoint. Representatives from the State’s health care infrastructure offered updates with Glause discussing WINhealth’s receivership process, while Forslund explained the state’s efforts for Medicaid expansion by putting expansion into the state budget instead of making it a standalone bill.
One of the discussion points offered by representatives from Cigna was the idea of an accountable care organization (ACO) in the state of Wyoming. The physicians in the room pointed out that effort had been done previously without positive results. McGinley said while a traditional ACO might not work, the state’s medical society is studying the feasibility of an Independent Practice Association, which might perform some of the same function.
The majority of the room was independent physicians with McGinley asking the audience at one point to raise their hands if they were independent physicians. All but two of the doctors in the room were independent with one of them – WMS President Sigsbee Duck – being from Rock Springs.
“I think offering the IPA as a way to go might be a good way to accomplish much of the same thing as an ACO,” McGinley said.
A number of physician issues were raised including national contracts with laboratories for pathology testing. One physician was concerned that there was a change in how the data is interpreted (what normal was to one machine versus another) and that local labs were being cut out. To their credit, the insurance companies said they were not aware of the issues involved with national lab contracts and were willing to discuss the issue further.
Another concern raised during the meeting was the concept that some insurance companies have a reputation for reimbursing patients for out-of-network visits instead of the physicians themselves. When the patient doesn’t use that cash to pay the doctor, physicians are left with the bill. Glause said he hasn’t heard that being an issue but if it does happen to contact his office immediately.
McGinley added that the event showed the importance of meeting at the county society level. He said in addition to some terrific conversation, the meeting also netted five new county society members and another organization announced it would also sign up each of its physicians.
“It creates a grass roots base,” McGinley said. “There are variations from county to county regarding what is important to that area. The individuals in the county are the ones who know what is important there. A strong county society also gives the state society a better idea to direct the information across the state. Without a lot of information at the county level, we are left making an educated guess on what is important to physicians in the state.”
McGinley said the event showed insurance companies are interested in participating with medical societies, pointing out the participating groups from Tuesday were going to share each of the resources, such as phone apps, that they have available for patients, as well as doctors.
“That went really well,” McGinley said. “I was pleased with turnout, participation, and the support. We had 10 legislators, physicians, and hospital administrators from all of the facilities in town. We have 110-112 members total. To have all of those insurance companies come into town with the bad weather, shows they are committed to what we are doing as a society and want to hear what we have to say.
“We are coming together to figure out answers,” Glause said. “Collectively, if we bring all of the stakeholders together, we can come up with some answers to some really tough questions.”